AB1540-HPR NURSING INTERVENTIONS FOR RHEUMATIC MUSCULOSKELETAL DISEASES (RMDS) PATIENTS ON BIOLOGIC THERAPY: A SYSTEMATIC LITERATURE REVIEW (SLR)
Authors: M. R. Melis, K. El Aoufy, C. Bruni, F. Bartoli, G. Fiori, S. Guiducci, S. Bellando Randone, S. Bambi, L. Rasero, M. Matucci-Cerinic
Journal: Annals of the Rheumatic Diseases (2022)

Background The support of the Rheumatology nurse to the management of patients who are affected by RMDs, characterized by remission and recrudescence and chronicity, may be strengthened by the investigation of their unmet needs and the identification of the necessary interventions to the continuity and quality of care. Objectives The aim of the present SLR is to identify the main nursing interventions to assure quality care in RMDs patients on biologic therapy. Methods Study design : a systematic search was conducted from 1990 to 2020 (01/01/1990- 2020/05/07). Inclusion criteria consisted of 1) patients with RMDs in accordance with American College of Rheumatology classification criteria and the American College of Rheumatology/European League against Rheumatism (ACR/EULAR); 2) in therapy with bDMARDS; 3) adult population &gt; 18 years; 4) primary research only; 6) English language; 7) abstract available; and 8) relative quantitative studies; 9) nursing interventions and/or outcomes. Data sources : Medline, CINAHL, PsycINFO and EMBASE databases were used to search for relevant studies. Review methods : using the predetermined inclusion/exclusion criteria, two independent reviewers (MRM, KEA) screened records selected for eligibility based on titles and abstracts. Records meeting the inclusion criteria were retrieved and full texts were further assessed. Critical Appraisal Skills Program (CASP) tools were used to evaluate the quality of the included studies. Data from 8 studies were extracted independently by the reviewers. Results 1805 articles were retrieved: after the review process, 8 articles met the inclusion criteria resulting in 1 randomized trial, 1 quasi-experimental study and 6 observational studies. The RMDs patient needs emerged concerning the psychosocial domain, the relationship with healthcare facilities and disease follow up to monitor symptoms. Moreover, three major nursing interventions related to these areas were identified: education, patient-centered care and data assessment. Conclusion Rheumatology nurses are part of a multidisciplinary team caring for patients on biologic therapy. Starting with accurate initial and ongoing data collection, rheumatology nurses can plan their interventions focusing primarily on patient education and tailored care based on actual needs. Further studies are necessary for research on aspects of patient-centered nursing care, including tele-nursing and Nursing Sensitive Outcomes in RMDs. References [1]EULAR, van Eijk-Hustings Y, van Tubergen A, Boström C, Braychenko E, Buss B, Felix J, Firth J, Hammond A, Harston B, Hernandez C, Huzjak M, Korandová J, Kukkurainen ML, Landewé R, Mezieres M, Milincovic M, Moretti A, Oliver S, Primdahl J, Scholte- Voshaar M, de la Torre-Aboki J, Waite-Jones J, Westhovens R, Zangi HA, Heiberg T, Hill J; “ Recommendations for the role of the nurse in the management of chronic inflammatory arthritis ”, Ann Rheum Dis. 2012 Jan;71(1):13-9. doi: 10.1136/annrheumdis-2011-200185. Epub 2011 Oct 28. [2]Larsson I. et al,“Randomized controlled trial of a nurse-led rheumatology clinic for monitoring biological therapy”Journal of Advanced Nursing 70(1), 164–175., 2013 [3]Betegnie,A.L. et al, “Why Do Patients with Chronic Inflammatory Rheumatic Diseases Discontinue Their Biologics? An Assessment of Patients’ Adherence Using a Self-report Questionnaire” The Journal of Rheumatology, 2016;43;724-730 [4]Giacomelli R. et al , “ Quality of life and unmet needs in patients with inflammatory arthropathies: results from the multicentre, observational RAPSODIA study .” Rheumatology (Oxford) 54(5): 792-797, 2015 [5]Ozkaraman A. et al , “ Effect of education and telephone counselling on adherence to treatment and challenges experienced in anti TNF-alfa treatment: a pilot study” Contemporary Nurse, ISSN: 1037-6178 (Print) 1839-3535 (Online), 2019 Disclosure of Interests None declared